The difference between cesarean section and caesarean section

Cesarean section is the same operation with a different name. It is also a relatively important operation during childbirth. There are two main methods of childbirth, one is natural childbirth and the other is cesarean section. Cesarean section is used within a certain range. For example, if the child is in distress, there is an abnormality in the pelvis, the fetal position is malposition, the delivery is not smooth, etc., then a cesarean section needs to be performed in time.

Scope of application

1. Fetal distress

Fetal distress can occur at any stage of pregnancy, especially in the late stages and after labor.

There are many causes of fetal distress, such as umbilical cord around the neck, placental dysfunction, meconium aspiration, or complications of the mother such as hypertension, diabetes, preeclampsia, etc. Most fetal distress can be detected by a fetal monitor showing a poor fetal heartbeat, or by ultrasound showing adverse changes in fetal blood flow. If the condition does not improve after emergency treatment by a physician, a cesarean section should be performed to quickly remove the fetus to prevent life-threatening danger.

2. Delayed labor

Labor delay refers to prolonged labor, which has a clear definition and classification in obstetrics. Usually the time of cervical dilation varies from person to person, but the average cervical dilation time of primiparas is longer than that of multiparas, taking 14 to 16 hours. If it exceeds 20 hours, it is called delayed labor. The mothers who encounter this situation suffer the most, because the labor pains have lasted for a while, so they have to change to a cesarean section. This means they have to experience both prenatal labor pain and postoperative pain, a total of two pains.

Generally, labor delay can be divided into three types according to the abnormalities of delivery: prolonged latent phase, prolonged active phase, and stagnation of active phase. Common causes of delayed labor may be abnormal uterine contraction strength, abnormal fetal body or fetal position or orientation, abnormal maternal birth canal, etc. If there is obvious labor delay and vaginal delivery is still chosen, it may cause harm to the fetus or mother, and a cesarean section must be performed.

3. Pelvic abnormalities

If the mother has pelvic structural abnormalities, such as polio patients, a history of pelvic fractures, a petite body or dwarfism, a cesarean section should be performed because the abnormal pelvic outlet cannot allow the fetus to pass smoothly. The asymmetry between the fetal head and the pelvic cavity is relative. That is to say, even if the mother's pelvic cavity is normal and not narrow, a cesarean section must be performed because the fetal head is too large to pass through the birth canal smoothly.

4. Malposition of the fetus

When the fetus of a primipara is in an abnormal position, cesarean section should be performed. Generally speaking, if a primipara has confirmed that the fetus is in an abnormal position at full term, a cesarean section can be scheduled in advance; but if the malposition of the fetus is discovered after labor pains begin, emergency surgery may have to be arranged directly. However, if the fetus is in an abnormal breech presentation and the mother wishes to give birth vaginally, various midwifery methods can still be tried. However, breech vaginal delivery still has a high risk, so the pros and cons should be discussed with the attending physician before it can be implemented.

5. Multiple births

If the mother is pregnant with twins and the fetal positions are normal, she can try natural delivery, but if she is pregnant with triplets or more, it is recommended to give priority to cesarean section.

Cesarean section for the first pregnancy

This is a common indication in China, accounting for about 30%. Many women will choose cesarean section for their next delivery after having a cesarean section for their first child. Generally speaking, a cesarean section for a previous pregnancy does increase the chance of uterine rupture by nearly 1%. If the hysterectomy is performed vertically, the chance of uterine rupture will increase by about 4 times. Therefore, most obstetricians and gynecologists and mothers will schedule the operation before entering labor, based on the premise of a cesarean section for the previous pregnancy.

6. Caesarean section due to placental factors

The position and changes of the placenta are also related to the method of delivery. For example, if the placenta is too low and blocks the opening of the cervix, placenta previa or the placenta separates from the uterine wall too early, causing heavy bleeding or fetal distress, these are all possible reasons for cesarean section.

7. The uterus has undergone surgery

This situation is similar to a cesarean section for the previous pregnancy. Because there is scar tissue left by the surgery on the uterine wall, this scar tissue does increase the risk of uterine rupture during labor, so most births will be arranged by cesarean section.

8. The mother is not suitable for vaginal delivery

If the mother has a major illness, such as preeclampsia or a serious medical disease (heart disease, etc.), and the doctor assesses that she is unable to give birth vaginally, she will also need to choose a cesarean section.

9. The fetus is too large

Macrosomia is defined as a fetal weight equal to or greater than 4 kg. During the prenatal examination, if the obstetrician assesses that the fetal weight may be greater than 4 kg and the chance of natural delivery is very small, a cesarean section can be arranged to avoid dystocia.